Active NPI
Branton Samson, DDS
- General Practice Dentistry
- Fort Wayne, IN
National Provider Identifier
1386487734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 12014710A
- Practice address
- 1717 S Calhoun St
Fort Wayne, IN 46802-5257 - Phone
- (260) 458-2641
- Fax
- (260) 426-0270
- NPI assigned
- Jun 14, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12014710A | IN | Primary |
Addresses
Primary practice location
1717 S Calhoun St
Fort Wayne, IN 46802-5257
Mailing address
6619 Brotherhood Way
Fort Wayne, IN 46825-4226
Phone (260) 739-1116
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neighborhood Health Clinics, Inc | General Practice | Current | Accepting new patients |
| Neighborhood Health Clinics, Inc | General Practice | Current | Accepting new patients |
Locations
1717 S Calhoun St
Fort Wayne, IN 46802
Phone (260) 458-2641
Interoperability endpoints
- branton.samson@nhci.eclinicaldirectplus.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754352000000",
"number": "1386487734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6619 BROTHERHOOD WAY",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468254226",
"telephone_number": "260-739-1116",
"fax_number": "260-426-0270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 S CALHOUN ST",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468025257",
"telephone_number": "260-458-2641",
"fax_number": "260-426-0270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMSON",
"first_name": "BRANTON",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-14",
"last_updated": "2025-08-05",
"certification_date": "2025-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IN",
"license": "12014710A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.